ABSTRACT
RESUMO Objetivo: Revisar as constatações científicas a respeito do método baby-led weaning (BLW) no âmbito da alimentação complementar. Fontes de dados: Buscas conduzidas na base de dados Sistema Online de Busca e Análise de Literatura Médica (MEDLINE)/PubMed em agosto de 2016 por dois examinadores independentes, sem delimitação de período. Foram utilizados os descritores: "baby-led weaning" OR "baby-led" OR "BLW". Critérios de inclusão: estudos originais, disponibilizados em inglês, que abordaram o tema do método BLW. Critérios de exclusão: referências em outros idiomas, artigos de opinião e de revisão da literatura, editoriais e publicações que não discorreram sobre o assunto pretendido. Das 97 referências identificadas, 13 foram incluídas na síntese descritiva. Síntese dos dados: Os bebês adeptos ao BLW, quando comparados aos do grupo em conduta alimentar tradicional, foram menos propensos ao excesso de peso, menos exigentes em relação ao alimento e consumiam os mesmos alimentos da família. Os episódios de engasgo não diferiram entre os grupos. As mães que optaram pela implementação do BLW exibiram mais escolaridade, ocupavam um cargo gerencial no trabalho e apresentaram maior probabilidade de terem amamentado até o sexto mês. Foram mencionados preocupações com bagunça nas refeições, desperdício de comida e engasgo/asfixia, mas a maioria recomendava a adoção do método. Os profissionais da saúde demonstraram receio em indicá-lo. Conclusões: O BLW foi sugerido pelas mães que o seguiram com seus filhos, todavia relataram-se preocupações, que, somadas ao receio dos profissionais acerca da capacidade dos bebês de se autoalimentarem, refletem escassez de conhecimento sobre o método.
ABSTRACT Objective: To review the scientific findings on the baby-led weaning method (BLW) in the context of complementary feeding. Data sources: Two independent examiners searched the Medical Literature Analysis and Retrieval System Online (MEDLINE)/PubMed database in August 2016. No time-period was defined for the publication dates. The following descriptors were used: "baby-led weaning" OR "baby-led" OR "BLW". Inclusion criteria were: original studies that were available in English, and which addressed the BLW method. Exclusion criteria were: references in other languages, opinion articles and literature reviews, editorials and publications that did not elaborate on the intended subject. Of the 97 references identified, 13 were included in the descriptive synthesis. Data synthesis: The BLW group of babies, when compared to the traditional eating group, were less prone to being overweight, less demanding of food, and ate the same foods as the family. The number of choking episodes did not differ between groups. Mothers who opted for the implementation of BLW had higher levels of schooling, held managerial positions at work, and were more likely to have breastfed until the sixth month of the child's life. Concerns were raised about messes made during meals, wasting food, and choking, but most of the mothers recommended adopting the method. Health professionals were hesitant to indicate this method. Conclusions: BLW was recommended by mothers who followed the method with their own children. However, concerns have been reported, which, coupled with professionals' fears about the inability of infants to self-feed, reflect a lack of knowledge about the method.
Subject(s)
Humans , Infant, Newborn , Infant , Weaning , Feeding Behavior , Infant Behavior , Infant Nutritional Physiological PhenomenaABSTRACT
Catheter ablation has become established as a gold standard therapy for patients suffering from many supraventricular and ventricular arrhythmias, offering a curative alternative to these patients by way of destroying or isolating the arrhythmia substrate. Radiofrequency has been used as a primary source of energy for transcatheter ablation due to its safety and efficacy. Another technique is transcoronary chemical ablation, consisting of the infusion of ethanol through the coronary blood supply to the site of origin of the arrhythmia. Most supraventricular arrhythmias like atrial tachycardia, atrioventricular nodal reentrant tachycardia and arrhythmias related to atrioventricular accessory pathways can be managed with radiofrequency catheter ablation. However, some concerns exist regarding the value of this technique for the treatment of atrial flutter and ventricular tachycardia. In this review we discuss the state-of-the-art in catheter ablation of cardiac arrhythmias and its future perspectives.